Provider Demographics
NPI:1821986639
Name:GLIMMER ELECTROLYSIS LLC
Entity type:Organization
Organization Name:GLIMMER ELECTROLYSIS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRAYLIN
Authorized Official - Middle Name:
Authorized Official - Last Name:MITCHELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:971-322-5909
Mailing Address - Street 1:13424 SE 169TH AVE APT A112
Mailing Address - Street 2:
Mailing Address - City:HAPPY VALLEY
Mailing Address - State:OR
Mailing Address - Zip Code:97015-8744
Mailing Address - Country:US
Mailing Address - Phone:971-322-5909
Mailing Address - Fax:
Practice Address - Street 1:16239 SE MCLOUGHLIN BLVD STE 208
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97267-4654
Practice Address - Country:US
Practice Address - Phone:971-322-5909
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-27
Last Update Date:2025-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty